HSBC Premier Family Application Form It is important you complete this application in full and sign as required, to enable us to consider your application. Please ensure all applicants sign the application overleaf. Missing information may cause a delay. Please use black ink and BLOCK CAPITALS to fill in your details below. in other cases, please tick clearly the appropriate box. Age 7 10? We ll open you an HSBC Premier MySavings account now and an HSBC Premier MyAccount when you turn 11. Age 11 17? Age 18-25? We ll now open you an HSBC Premier MySavings account and an HSBC Premier MyAccount. We ll now open you an HSBC Premier Family Savings account. For Branch use only Branch sort code You can open an HSBC Premier Family account(s) at any HSBC branch or by giving us a call. However, if you d prefer, just complete this form and take it to your local branch, we ll then write to you within five to seven days with details of your new account(s). To open an HSBC Premier MyMoney account(s) you ll need to provide proof of who you are eg, your Passport or Birth Cerificate and proof of your address if you don t currently live with your parent/guardian, such as a recent utility bill. What is the purpose of the account? For all ages (7-10, 11-17 and 18-25). The following is a generic list and could apply to any HSBC product. Not all of the options will be applicable to this particular product for the lower age categories, but do select all that apply: Regular Household expenses Personal expenses mandated credits Savings Standing order Cash exchanges Student fees Foreign transactions to an individual (in and out) Other (Please specifiy) For ages 18 25 The following additional options may also be applicable for 18-25 year olds, please select all that apply: Children s education Loan payments Gambling fees/charges Other (Please specifiy) The following questions that follow in sections 1-5 apply to all age categories (7-10, 11-17 and 18-25) and apply to the owner of the account between the ages 7 and 25 years old. Parents are advised to assist younger account holders while answering some of these questions. If you have an existing account with HSBC, please provide your sort code and account number. HSBC account number Do you wish this relationship to continue? Yes No 1. Personal Details Title Mr Mrs Miss Ms Surname First name(s) Date of birth Gender Male Female Country of Birth Nationality/Citizenship (If you hold more than one include these below you may include up to three) Nationality/Citizenship 1 Nationality/Citizenship 2 Nationality/Citizenship 3
In which country are you a resident for tax purposes (If you hold more than one, include these below you may include up to three) Country 1 Country 2 Country 3 2. Contact details Permanent home address Date moved to this address Please give your previous address if you ve been at your present address for less than three years Previous Address Date moved to this address Home Tel. No. Ex directory Yes No Mobile Tel. No Ex directory Yes No Email address If you re aged 11-17 we ll send you a debit card to use on your HSBC Premier MyAccount. If you don t want this please tick the box below. 11-17 years old: No debit card 3. Employment and Education Some of the following questions or options will not apply to the younger age groups but may apply to those up to the age of 25. Please complete as many questions as possible and as applicable. Parents are advised to assist younger account holders while answering some of these questions. Are you: A Student/pupil Employed full-time Employed part-time Self Employed (at school, college or university) Other full time education A Homemaker Unemployed If you are a pupil / student please state the name of the school, college or university you are attending The following questions will not apply to the 7-11 age category, but might apply to older age categories up to the age of 25. If you are in employment/self-employed please complete: Employer s name Business address (in full) Nature of business Date commenced in present employment Occupation If self-employed, at which bank is your business account held? If you are employed, what is your occupation?
4. Your Home Details Some of the following questions or options will not apply to the younger age groups but may apply to those up to the age of 25. Please complete as many questions as possible and as applicable. Parents are advised to assist younger account holders while answering some of these questions. Are you: A homeowner A tenant Living with family Halls of residence Other Please specify If you are a homeowner please also give: Estimated value of your home Name of lender Mortgage outstanding 5. Financial Information As part of our on going commitment to managing financial crime risk, we need to ask you the following questions about how you intend to use your account. Not all of the questions and options that follow will apply to younger age categories but please answer as accurately as you can and as applicable. Parents are advised to assist younger account holders while answering some of these questions. Only answer the below if you are in full time or part time employment, or if you are receiving a student loan or grant. What is your total annual income (Before tax and deductions)? Net Monthly income Net Monthly expenditure When are you paid? (eg, every Thursday, 20th, monthly, etc.) How are you paid? Cash Cheque Direct to Bank/BACS Will your income be paid directly into this account? Yes No Will there be any other regular monthly credits paid into the account (this will be income outside of your main income) Yes No If you answered yes to the question above, what will be the source of these regular monthly credits? (Tick one) Employment pay Benefit/Welfare Pension payment Transfer/Standing Order Transfer/Standing Order from personal account (HSBC) from personal account (non-hsbc) Student Loan Other (please specify) How much cash do you expect to pay in to the account on a regular monthly basis? 0 1-100 101-250 251-500 501+ What is the source of these cash deposits? Salary Sale of personal goods Gambling Gift Other (please specify) The following questions will not apply to the younger age groups but may apply to those up to the age of 25. Please complete as many questions as possible and as applicable. What is the source of any other funds being paid into the account? (tick all that apply) Savings from employment Inheritance Pension lump sum payment Sale of Property/ Assets Personal loans Re-mortgage Commercial loan Redundancy payment Lottery/Gaming win Investments Family Loan No other sources of fund Other (please specify) How much will the initial deposit into the account be? (Your first payment into the account) What is the total value of fund to be paid into the account? (this should be the estimated amount you expect to be paid into the account over the next three months and should be the combined income for regular credits and any other source of funds.)
Do you expect to make transactions to/receive transactions from countries other than the UK? Yes No If you have answered yes to the previous question, please specify which country and currencies below (you may include up to 5) If you have answered yes to the previous questions, what is the approximate value of these transactions over the next 12 months? 0-500 501-1000 1001-5000 5000-10,000 10,001 + How many of these transactions to/from counties other than the UK do you expect to make over the next 12 months? 1-5 6+ Do you hold: Other credit cards Other debit cards Do you have an account with another bank held outside of the UK? No Yes within EU Yes outside the EU Yes Both; Within and outside the EU Please give the name of your Bank or Building society Account number Is this relationship to continue Yes No 6. Parent/legal guardian s details (To be completed by the parent/legal guardian) Please provide sort code and account number of your existing HSBC Premier account. HSBC account number Title Mr Mrs Miss Ms Date of birth Surname First Name(s) Please confirm your address is the same as that given in section 2 Permanent Home Address If not please provide your address below Country (if not UK) What is your employment status? Employed full-time Employed part-time Self employed A Homemaker Unemployed A student Receiving a pension If you are employed, what is your occupation?
7. Your Information In this form, we, us and our refer to HSBC Bank plc and HSBC Group means collectively and individually, HSBC Holdings plc, its affiliates, subsidiaries, associated entities and any of their branches and offices, and any member of the HSBC Group has the same meaning. HSBC Bank plc will collect and use your personal information to process your application, in accordance with the MyMoney and HSBC Premier Family Terms and Conditions, copies of which you have received. Credit reference agencies We may share information with credit reference agencies to verify your identity and suitability for an account, using information from the Electoral Register and other public sources. By applying for a current account or credit, we may use details of your credit history to assess your ability to meet your financial commitments. The credit reference agencies will record details which will form part of your credit history whether or not you proceed with your application. If you make several applications within a short period of time this may temporarily affect your ability to obtain credit. If you make a joint application for a current account or credit, an association linking your financial records with those of your fellow applicant(s) will be created by the credit reference agencies. The credit history of your associates may be taken into consideration in any future application for credit. Further information on credit scoring, credit reference and fraud prevention agencies Further details on credit scoring and explaining how information held by CRAs and fraud prevention agencies may be used is set out in a leaflet entitled Credit Scoring, Credit Reference and Fraud Prevention Agencies available on our website hsbc.co.uk or can be requested from branches or by phoning 0800 587 7008 (textphone 08457 125 563). Please call this number if you require details of the credit reference and fraud prevention agencies we use. Lines are open 8.30am to 6pm Monday to Friday, excluding public holidays. Information about Products, Services and Promotions If you agree, the HSBC Group may use and share relevant information about you, your transactions and your relationships with the HSBC Group, to give you information about products, services (including mortgages) and promotions available from members of HSBC Group and selected third parties which may interest you by post, telephone, electronic and other means. By completing this application you will be consenting to the use of your information for this unless you tick the appropriate box(es) below to indicate that you do not wish to receive such information; No post No telephone No email No mobile messaging (eg, SMS) No secure e-messaging (email through internet banking) By signing this application, you agree that we can use your information in the way set out above and in the MyMoney and HSBC Premier Family Terms and Conditions, copies of which you have received. Applicant I request you to open the appropriate account (or accounts) in my name for my age as set out above. I agree that my account(s) will be subject to the MyMoney and HSBC Premier Family Terms and Conditions and price list, copies of which I have received. I confirm that the information given is accurate and true to the best of my knowledge. By signing this application, I agree that my Parents will be able to enquire about by accounts if I am under the age of 18. Your signature Parent/legal guardian I request you to open an account (or accounts) in my dependent s name. I agree that the account(s) will be subject to the MyMoney and HSBC Premier Family Terms and Conditions and price list, copies of which I and the applicant have received. I agree that the applicant will qualify for the emergency encashment subject to my approval when it is needed. If I cease to qualify as an HSBC Premier Customer, the applicant will be informed of this. I confirm that the information given is accurate and true to the best of my knowledge. By signing below I agree that you can open the appropriate account(s) for the applicant and that you may share information with credit reference agencies (CRA s) to verify my identity. This will include the use of information from the Electoral register and other public sources. CRA s record details of the search even if we do not proceed but the search will not be seen or used by lenders to assess your ability to obtain credit. If your child is under 11 we will require your consent for withdrawals or transfers over 50 from a MySavings account. Parent/legal guardian s signature
8. For parents/legal guardians wishing to make a regular payment: If you would like to set up regular payments from an HSBC account into one of these accounts for your child, please fill in the details below. If you would like to set up a standing order from a bank account other than HSBC, please ask for a form from your bank. Standing Order request Please create a new standing order from: Please indicate the account you would like to credit: HSBC account number HSBC Premier MySavings HSBC Premier MyAccount HSBC Premier Family Savings (If you don t specify an account, we will set up the standing order to credit HSBC Premier MySavings or HSBC Premier Family Savings). Amount Frequency Weekly / Monthly / Quarterly Date of first (Delete as apporopriate) Payment Signature For branch use only: Mandatory details must complete Branch sort code Branch signature Name of branch signatory Date of signature HSBC Premier HSBC Premier MyAccount no. MySavings account no. HSBC Premier Family Savings Account no. hsbc.co.uk Issued by HSBC Bank plc HSBC Bank plc, Customer Information, PO Box 6201, Coventry CV3 9HW NJCOMP3 MCP43595 06/14 HSBC Bank plc 2014. All Rights Reserved.